INTRODUCTION: The recent growth in the popularity of the hospice concept as a means of caring for terminally ill patients leads to the observation that patients and families perceive needs for care lacking within our traditional medical system. One reason for this dissatisfaction may be the failure of the patient, family, and physician to possess similar treatment objectives, particularly when the transition is being made from aggressive treatment to palliative care. HYPOTHESIS: The primary hypothesis of this study is that satisfaction with the conduct and outcome of the terminal phase is directly related to agreement among the patient, family, and physician on the objectives and expectations of treatment. Agreement, or congruence, is necessary for a smooth transition from the period of aggressive, tumor-directed therapy (Phase II) to the period of palliative or terminal care (Phase III). Conversely, Incongruence, or lack of agreement about treatment objectives will be related to a sub-optimal terminal phase in terms of greater dissatisfaction, physical and psychological distress for both patient and family. GOAL: From data collected on the relationship between congruence and outcome, the study expects to demonstrate the need for developing, implementing and evaluating prophylactic and therapeutic interventions to promote congruence and/or satisfactory outcome.